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Appendix 1 : Antibiotic Dosages In Patients With Impaired Renal Function (Adult)



 Unless stated, adjusted doses are % of dose for normal renal function
 For critical care patient, kindly refer to Guide to Antimicrobial Therapy in the Adult ICU 2017


 CrCl (ml/min)=            (140-Age)   x    BW (kg)              x (1.04 for female) or (1.23 for males)
                                      Serum creatinine (micromol/l)


 ADJUSTMENT FOR RENAL FAILURE
 DOSE FOR NORMAL   Estimated creatinine clearance (CrCl),   SUPPLEMENT FOR
 ANTIBACTERIAL                                        COMMENTS
 RENAL FUNCTION   ml/min         DIALYSIS
 > 50   10-50    < 10

 Aminoglycoside


 Amikacin   7.5mg/kg q12h or   100%   100%   100%   Extra 1/2 of normal   Dosage adjustment
 15mg/kg/day      q24-72h   q48h-72h   renal function dose AD  should be based on
    by levels   by levels                        TDM level where
                                                 possible

 Gentamicin   1.7mg/kg q8h or   100%   100%   100%   Extra 1/2 of normal
       5mg/kg/day      q12-48h   q48-72h   renal function dose AD
       by levels   by levels


 Streptomycin   15mg/kg (max. of 1gm)   100%   100%   100%   Extra 1/2 of normal
 q24h   q24-72h   q72-96h   renal function dose AD


 AD = after dialysis. “Dose AD” refers only to timing of dose with NO extra drug
 D = dosage reduction, I = interval extension, SGC=Soft gel capsule, HD – Haemodialysis, PD – Peritoneal dialysis








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